General anxiety, depression, and physical health in relation to symptoms of heart-focused anxietya cross sectional study among patients living with the risk of serious arrhythmias and sudden cardiac death

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General anxiety, depression, and physical health in relation to symptoms of heart-focused anxietya cross sectional study among patients living with the risk of serious arrhythmias and sudden cardiac death

Subject:

Abstract:

Objective: To investigate the role of three distinct symptoms of heart-focused anxiety (cardio-protective avoidance,
heart-focused attention, and fear about heart sensations) in relation to general anxiety, depression and physical health
in patients referred to specialized cardio-genetics outpatient clinics in Norway for genetic investigation and counseling.
Methods: Participants were 126 patients (mean age 45 years, 53.5% women). All patients were at higher risk than
the average person for serious arrhythmias and sudden cardiac death (SCD) because of a personal or a family
history of an inherited cardiac disorder (familial long QT syndrome or hypertrophic cardiomyopathy). Patients filled
in, Hospital Anxiety and Depression Scale, Short-Form 36 Health Survey, and Cardiac Anxiety Questionnaire, two
weeks before the scheduled counseling session.
Results: The patients experienced higher levels of general anxiety than expected in the general population (mean
difference 1.1 (p < 0.01)). Hierarchical regression analyses showed that avoidance and fear was independently
related to general anxiety, depression, and physical health beyond relevant demographic covariates (age, gender,
having children) and clinical variables (clinical diagnosis, and a recent SCD in the family). In addition to heartfocused
anxiety, having a clinical diagnosis was of importance for physical health, whereas a recent SCD in the
family was independently related to general anxiety and depression, regardless of disease status.
Conclusion: Avoidance and fear may be potentially modifiable symptoms. Because these distinct symptoms may
have important roles in determining general anxiety, depression and physical health in at-risk individuals of
inherited cardiac disorders, the present findings may have implications for the further development of genetic
counseling for this patient group.